Regional oximetry user interface

ABSTRACT

A regional oximetry system has a display and at least one processor causing a plurality of views to be displayed on the display, each configured to occupy at least a portion of the display. The views are adapted to present data responsive to at least one physiological signal. A first sensor port is configured to receive at least a first physiological signal representative of a regional tissue oxygenation level, and a second sensor port is configured to receive at least a second physiological signal representative of an arterial oxygen saturation level. One view presents a first trend graph of the first physiological signal and a second trend graph of the second physiological signal. An area between the first trend graph and the second trend graph can include a differential analysis of regional-to-central oxygen saturation.

PRIORITY CLAIM AND RELATED APPLICATIONS

Any and all applications for which a foreign or domestic priority claimis identified in the Application Data Sheet as filed with the presentapplication are hereby incorporated by reference under 37 CFR 1.57.

This application is a continuation of U.S. patent application Ser. No.14/507,660, filed Oct. 6, 2014, which claims a priority benefit under 35U.S.C. § 119 to the following U.S. Provisional Patent Applications:

Serial No. Date Title 61/887,856, Oct. 7, 2013, Regional OximetrySensor, 61/887,878, Oct. 7, 2013, Regional Oximetry Pod, 61/887,883,Oct. 7, 2013, Regional Oximetry User interface, and 62/012,170, Jun. 13,2014 Peel-Off Resistant Regional Oximetry Sensor.

Each of the foregoing disclosures is incorporated by reference herein inits entirety.

FIELD OF THE DISCLOSURE

The present disclosure relates generally to patient monitoring devicesand systems, and specifically to improving user interaction with apatient monitor and medical data communication hub.

BACKGROUND OF THE DISCLOSURE

Regional oximetry, also referred to as tissue oximetry and cerebraloximetry, enables the continuous assessment of the oxygenation oftissue. The measurement is taken by placing one or more sensors on apatient, frequently on the patient's left and right forehead. Regionaloximetry estimates regional tissue oxygenation by transcutaneousmeasurement of areas that are vulnerable to changes in oxygen supply anddemand. Regional oximetry exploits the ability of light to penetratetissue and determine hemoglobin oxygenation according to the amount oflight absorbed by hemoglobin.

Regional oximetry differs from pulse oximetry in that tissue samplingrepresents primarily (70-75%) venous, and less (20-25%) arterial blood.The technique uses two photo-detectors with each light source, therebyallowing selective sampling of tissue beyond a specified depth beneaththe skin. Near-field photo-detection is subtracted from far-fieldphoto-detection to provide selective tissue oxygenation measurementbeyond a pre-defined depth. Moreover, regional oximetry monitoring doesnot depend upon pulsatile flow.

Regional oximetry is a useful patient monitoring technique to alertclinicians to dangerous clinical conditions. Changes in regionaloximetry have been shown to occur in the absence of changes in arterialsaturation or systemic hemodynamic parameters.

SUMMARY

The present disclosure provides a regional oximetry system with improveduser interaction. In one aspect of the regional oximetry system, adisplay is provided, and a processor is provided causing a plurality ofviews to be displayed on the display. The views are configured to occupyat least a portion of the display. In some embodiments a first sensorport is configured to receive a first physiological signalrepresentative of a regional tissue oxygenation level. In someembodiments a second sensor port is configured to receive a secondphysiological signal representative of an arterial oxygen saturationlevel. In some embodiments, the views are adapted to present dataresponsive to at least one physiological signal. In some embodiments,one view presents a first trend graph of a first physiological signalrepresentative of a regional tissue oxygenation level, and a secondtrend graph of a second physiological signal representative of anarterial oxygen saturation level. In some embodiments an area betweenthe first trend graph and the second trend graph can include adifferential analysis of regional-to-central oxygen saturation.

Another aspect of a regional oximetry system includes obtaining a firstwaveform responsive to a physiological signal representative of aregional tissue oxygenation level, obtaining a second waveformresponsive to a physiological signal representative of an arterialoxygen saturation level, determining, using at least one processor, adata trend responsive to the first physiological signal, determining,using at least one processor, a data trend responsive to the secondphysiological signal, and determining, using the at least one processor,a difference between the data trend responsive to the firstphysiological signal and the data trend responsive to the secondphysiological signal. In some embodiments, the regional oximetry systemfurther presents, in a first display view, the determined data trendsresponsive to the first and second physiological signals, and in asecond display view, the determined difference between the data trendresponsive to the first and second physiological signals.

Yet another aspect of a regional oximetry system is a display and aprocessor causing a plurality of views to be displayed on the display.In some embodiments the views are configured to occupy at least aportion of the display. The views are adapted to present data responsiveto at least one physiological signal. In some embodiments a first sensorport is configured to receive a first physiological signalrepresentative of a regional tissue oxygenation level. In someembodiments the processor is configured to set a baseline levelrepresentative of an acceptable state of the regional tissueoxygenation. One view, for example, can present a differential analysisof a physiological signal representative of a regional tissueoxygenation level and a baseline level representative of an acceptablestate of regional tissue oxygenation.

In yet another aspect of a regional oximetry system a display isprovided, a sensor port is provided that is adapted to communicate withat least one sensor, and a processor is provided causing a plurality ofviews to be displayed on the display. The views are configured to occupyat least a portion of the display. A set sensor menu view is configuredto occupy at least a portion of the display and is adapted to present aconnectivity status of the sensor port and the at least one sensor.

For purposes of summarizing the disclosure, certain aspects, advantages,and novel features have been described herein. Of course, it is to beunderstood that not necessarily all such aspects, advantages, orfeatures will be embodied in any particular embodiment.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings and the associated descriptions are provided toillustrate embodiments of the present disclosure and do not limit thescope of the claims.

FIGS. 1A-1C are perspective views of a medical monitoring hub;

FIG. 2 is a simplified block diagram of a medical monitoringenvironment;

FIG. 3 is a simplified hardware block diagram of a medical monitoringsystem;

FIG. 4 is a finger control gesture legend for a touchscreen interface;

FIG. 5 is an illustration of a display view;

FIGS. 6A-6B are illustrations of potential regional oximetry sensor sitelocations for an adult and for a child, respectively;

FIG. 7 is an illustration of a regional oximetry display;

FIG. 8 is an illustration of a medical monitoring hub display;

FIGS. 9A-9B illustrate embodiments for regional oximetry monitoring;

FIGS. 10A-10F illustrate embodiments of a user interface for selecting aregional oximetry sensor site;

FIGS. 11A-11G illustrate embodiments of a user interface for setting abaseline for a regional oximetry sensor;

FIGS. 12A-12F illustrate embodiments of a user interface for setting asource for measuring arterial oxygen saturation;

FIGS. 13A-13E illustrate embodiments of a user interface for settingparameters of a sensor used in a regional oximetry system;

FIG. 14 illustrates an embodiment of a display of regional oximetrybaseline delta measurements; and

FIGS. 15A-15B illustrate embodiments of a display of regional-to-centraloxygenation saturation measurements.

While the foregoing “Brief Description of the Drawings” referencesgenerally various embodiments of the disclosure, an artisan willrecognize from the disclosure herein that such embodiments are notmutually exclusive. Rather, the artisan would recognize a myriad ofcombinations of some or all of such embodiments.

DETAILED DESCRIPTION

The following description is merely illustrative in nature and is in noway intended to limit the disclosure, its application, or uses. Forpurposes of clarity, the same reference numbers will be used in thedrawings to identify similar elements. It should be understood thatsteps within a method may be executed in different order withoutaltering the principles of the present disclosure.

The present disclosure relates to a user interface for a medicalmonitoring hub configured to be the center of monitoring activity for agiven patient. An example of a medical monitoring hub is disclosed inU.S. patent application Ser. No. 13/651,167 assigned to the assignee ofthe present disclosure, and is incorporated by reference herein.

In an embodiment, the hub comprises a large, easily-readable display,such as an about ten (10) inch display dominating the majority of realestate on a front face of the hub. The display could be much larger ormuch smaller depending upon design constraints. However, for portabilityand current design goals, the preferred display is roughly sizedproportional to the vertical footprint of one of the dockable portablepatient monitors. Other considerations are recognizable by those skilledin the art from the disclosure herein.

The display provides measurement data for a wide variety of monitoredparameters for the patient under observation in numerical or graphicform. In various embodiments, the measurement data is automaticallyconfigured based on the type of data and information being received atthe hub. In an embodiment, the hub is moveable, portable, and mountableso that it can be positioned to convenient areas within a caregiverenvironment. For example, the hub is collected within a singularhousing.

In an embodiment, the hub may advantageously receive data from aportable patient monitor while docked or undocked from the hub. Typicalportable patient monitors, such as oximeters or co-oximeters can providemeasurement data for a large number of physiological parameters derivedfrom signals output from optical and/or acoustic sensors, electrodes, orthe like. The physiological parameters include, but are not limited tooxygen saturation (including arterial blood oxygenation, regionaloximetry (also known as tissue oximetry and cerebral oximetry),carboxyhemoglobin, methemoglobin, total hemoglobin, glucose, pH,bilirubin, fractional saturation, pulse rate, respiration rate,components of a respiration cycle, indications of perfusion includingperfusion index, signal quality and/or confidences, plethysmograph data,indications of wellness or wellness indexes or other combinations ofmeasurement data, audio information responsive to respiration, ailmentidentification or diagnosis, blood pressure, patient and/or measurementsite temperature, depth of sedation, organ or brain oxygenation,hydration, measurements responsive to metabolism, combinations of thesame or the like, to name a few. In other embodiments, the hub mayoutput data sufficient to accomplish closed-loop drug administration incombination with infusion pumps or the like.

In an embodiment, the hub communicates with other devices that areinteracting with the patient in a number of ways in a monitoringenvironment. For example, the hub advantageously receives serial datafrom other devices without necessitating their reprogramming or that ofthe hub. Such other devices include pumps, ventilators, all manner ofmonitors monitoring any combination of the foregoing parameters,ECG/EEG/EKG devices, electronic patient beds, and the like. Moreover,the hub advantageously receives channel data from other medical deviceswithout necessitating their reprogramming or that of the hub. When adevice communicates through channel data, the hub may advantageouslyalter the large display to include measurement information from thatdevice. Additionally, the hub accesses call systems, such as those usedby nurses or other attendants, to ensure that call situations from thedevice are passed to the appropriate nurse or attendant call system.

The hub also communicates with hospital systems to advantageouslyassociate incoming patient measurement and treatment data with thepatient being monitored. For example, the hub may communicate wirelesslyor otherwise to a multi-patient monitoring system, such as a server orcollection of servers, which in turn may communicate with a caregiver'sdata management systems, such as, for example, an Admit, Discharge,Transfer (“ADT”) system and/or an Electronic Medical Records (“EMR”)system. The hub advantageously associates the data flowing through itwith the patient being monitored, thereby providing the electronicmeasurement and treatment information to be passed to the caregiver'sdata management systems without the caregiver associating each device inthe environment with the patient.

In an embodiment, the hub advantageously includes a reconfigurable andremovable docking station. The docking station may dock additionallayered docking stations to adapt to different patient monitoringdevices. Additionally, the docking station itself is modularized so thatit may be removed if the primary dockable portable patient monitorchanges its form factor. Thus, the hub is flexible in how its dockingstation is configured.

In an embodiment, the hub includes a large memory for storing some orall of the data it receives, processes, and/or associates with thepatient, and/or communications it has with other devices and systems.Some or all of the memory may advantageously comprise removable SDmemory.

The hub communicates with other devices through at least (1) the dockingstation to acquire data from a portable monitor, (2) innovativeuniversal medical connectors to acquire channel data, (3) serial dataconnectors, such as RJ ports to acquire output data, (4) Ethernet, USB,and nurse call ports, (5) Wireless devices to acquire data from aportable monitor, and (6) other wired or wireless communicationmechanisms known to an artisan. The universal medical connectorsadvantageously provide optional electrically-isolated power andcommunications, and are designed to be smaller in cross section thanother commonly-used isolation configurations. The connectors and the hubcommunicate to advantageously translate or configure data from otherdevices to be usable and displayable for the hub. In an embodiment, asoftware developers kit (“SDK”) is provided to a device manufacturer toestablish or define the behavior and meaning of the data output fromtheir device. When the output is defined, the definition is programmedinto a memory residing in the cable side of the universal medicalconnector and supplied as an original equipment manufacturer (“OEM”) tothe device provider. When the cable is connected between the device andthe hub, the hub understands the data and can use it for display andprocessing purposes without necessitating software upgrades to thedevice or the hub. In an embodiment, the hub can negotiate the schemaand even add additional compression and/or encryption. Through the useof the universal medical connectors, the hub organizes the measurementand treatment data into a single display and alarm system effectivelyand efficiently, bringing order to the monitoring environment.

As the hub receives and tracks data from other devices according to achannel paradigm, the hub may advantageously provide processing tocreate virtual channels of patient measurement or treatment data. In anembodiment, a virtual channel may comprise a non-measured parameter thatis, for example, the result of processing data from various measured orother parameters. An example of such a parameter includes a wellnessindicator derived from various measured parameters that give an overallindication of the wellbeing of the monitored patient. An example of awellness parameter is disclosed in U.S. patent application Ser. Nos.13/269,296, 13/371,767 and 12/904,925, by the assignee of the presentdisclosure and incorporated by reference herein. By organizing data intochannels and virtual channels, the hub may advantageously time-wisesynchronize incoming data and virtual channel data.

The hub also receives serial data through serial communication ports,such as RJ connectors. The serial data is associated with the monitoredpatient and passed on to the multi-patient server systems and/orcaregiver backend systems discussed above. Through receiving the serialdata, the caregiver advantageously associates devices in the caregiverenvironment, often from varied manufacturers, with a particular patient,avoiding a need to have each individual device associated with thepatient communicating independently with hospital systems. Suchassociation is vital as it reduces caregiver time spent enteringbiographic and demographic information about the patient into eachdevice. Moreover, in an embodiment, through the SDK the devicemanufacturer may advantageously provide information associated with anymeasurement delay of their device, thereby further allowing the hub toadvantageously time-wise synchronize serial incoming data and other dataassociated with the patient.

In an embodiment, when a portable patient monitor is docked, and itincludes its own display, the hub effectively increases its display realestate. For example, in an embodiment, the portable patient monitor maysimply continue to display its measurement and/or treatment data, whichmay be now duplicated on the hub display, or the docked display mayalter its display to provide additional information. In an embodiment,the docked display, when docked, presents anatomical graphical data of,for example, the heart, lungs, organs, the brain, or other body partsbeing measured and/or treated. The graphical data may advantageouslyanimate similar to and in concert with the measurement data. Forexample, lungs may inflate in approximate correlation to the measuredrespiration rate and/or the determined inspiration/expiration portionsof a respiration cycle; the heart may beat according to the pulse rateor along generally understood actual heart contraction patterns; thebrain may change color or activity based on varying depths of sedation;or the like. In an embodiment, when the measured parameters indicate aneed to alert a caregiver, a changing severity in color may beassociated with one or more displayed graphics, such as the heart,lungs, brain, organs, circulatory system or portions thereof,respiratory system or portions thereof, other body parts or the like. Instill other embodiments, the body portions may include animations onwhere, when or how to attach measurement devices.

The hub may also advantageously overlap parameter displays to provideadditional visual information to the caregiver. Such overlapping may beuser definable and configurable. The display may also incorporateanalog-appearing icons or graphical indicia.

In the interest of clarity, not all features of an actual implementationare described in this specification. An artisan will of courseappreciate that in the development of any such actual implementation (asin any development project), numerous implementation-specific decisionsmust be made to achieve a developer's specific goals and sub-goals, suchas compliance with system and business-related constraints, which willvary from one implementation to another. Moreover, it will beappreciated that such a development effort might be complex andtime-consuming, but would nevertheless be a routine undertaking ofdevice and systems engineering for those of ordinary skill having thebenefit of this disclosure.

To facilitate a complete understanding of the disclosure, the remainderof the detailed description describes the disclosure with reference tothe drawings, wherein like reference numbers are referenced with likenumerals throughout.

FIG. 1A illustrates a perspective view of an embodiment of a medicalmonitoring hub 100 with an embodiment of a docked portable patientmonitor 102 according to an embodiment of the disclosure. The hub 100includes a display 104, and a docking station 106, which in anembodiment is configured to mechanically and electrically mate with theportable patient monitor 102, each housed in a movable, mountable andportable housing 108. The housing 108 includes a generally uprightinclined shape configured to rest on a horizontal flat surface, althoughthe housing 108 can be affixed in a wide variety of positions andmountings and comprise a wide variety of shapes and sizes.

In an embodiment, the display 104 may present a wide variety ofmeasurement and/or treatment data in numerical, graphical, waveform, orother display indicia 110. In an embodiment, the display 104 occupiesmuch of a front face of the housing 108, although an artisan willappreciate the display 104 may comprise a tablet or tabletop horizontalconfiguration, a laptop-like configuration or the like. Otherembodiments may include communicating display information and data to atable computer, smartphone, television, or any display systemrecognizable to an artisan. The upright inclined configuration of FIG.1A presents display information to a caregiver in an easily viewablemanner.

FIG. 1B shows a perspective side view of an embodiment of the hub 100including the housing 108, the display 104, and the docking station 106without a portable monitor docked. Also shown is a connector fornoninvasive blood pressure (NIBP) 113.

In an embodiment, the housing 108 may also include pockets orindentations to hold additional medical devices, such as, for example, ablood pressure monitor or temperature sensor 112, such as that shown inFIG. 1C.

The portable patient monitor 102 of FIG. 1A may advantageously comprisean oximeter, co-oximeter, respiratory monitor, depth of sedationmonitor, noninvasive blood pressure monitor, vital signs monitor or thelike, such as those commercially available from Masimo Corporation ofIrvine, Calif., and/or disclosed in U.S. Pat. Pub. Nos. 2002/0140675,2010/0274099, 2011/0213273, 2012/0226117, 2010/0030040; U.S. Pat. App.Ser. Nos. 61/242,792, 61/387457, 61/645,570, Ser. No. 13/554,908 andU.S. Pat. Nos. 6,157,850, 6,334,065, and the like. The portable patientmonitor 102 may communicate with a variety of noninvasive and/orminimally invasive devices such as optical sensors with light emissionand detection circuitry, acoustic sensors, devices that measure bloodparameters from a finger prick, cuffs, ventilators, and the like. Theportable patient monitor 102 may include its own display 114 presentingits own display indicia 116. The display indicia 116 may advantageouslychange based on a docking state of the portable patient monitor 102.When undocked, the display indicia 116 may include parameter informationand may alter orientation based on information provided by, for example,a gravity sensor or an accelerometer.

In an embodiment, the docking station 106 of the hub 100 includes amechanical latch 118, or a mechanically releasable catch to ensure thatmovement of the hub 100 doesn't mechanically detach the portable patientmonitor 102 in a manner that could damage the same.

Although disclosed with reference to particular portable patientmonitors 102, an artisan will recognize from the disclosure herein thereis a large number and wide variety of medical devices that mayadvantageously dock with the hub 100. Moreover, the docking station 106may advantageously electrically and not mechanically connect with themonitor 102, and/or wirelessly communicate with the same.

FIG. 2 illustrates a simplified block diagram of a monitoringenvironment 200 including the hub 100 of FIGS. 1A-1C, according to anembodiment of the disclosure. As shown in FIG. 2, the environment mayinclude the portable patient monitor 102 communicating with one or morepatient sensors 202, such as, for example, oximetry optical sensors,acoustic sensors, blood pressure sensors, respiration sensors or thelike. In an embodiment, additional sensors, such as, for example, a NIBPsensor or system 211 and a temperature sensor or sensor system 213 maycommunicate directly with the hub 100. The sensors 202, 211 and 213 whenin use are typically in proximity to the patient being monitored if notactually attached to the patient at a measurement site.

As disclosed, the portable patient monitor 102 communicates with the hub100, in an embodiment, through the docking station 106 when docked and,in an embodiment, wirelessly when undocked, however, such undockedcommunication is not required. The hub 100 communicates with one or moremulti-patient monitoring servers 204 or server systems, such as, forexample, those disclosed with in U.S. Pat. Pub. Nos. 2011/0105854,2011/0169644, and 2007/0180140. In general, the server 204 communicateswith caregiver backend systems 206 such as EMR and/or ADT systems. Theserver 204 may advantageously obtain through push, pull or combinationtechnologies patient information entered at patient admission, such asdemographical information, billing information, and the like. The hub100 accesses this information to seamlessly associate the monitoredpatient with the caregiver backend systems 206. Communication betweenthe server 204 and the monitoring hub 100 may be accomplished by anytechnique recognizable to an artisan from the disclosure herein,including wireless, wired, over mobile or other computing networks, orthe like.

FIG. 2 also shows the hub 100 communicating through its serial dataports 210 and channel data ports 212. As disclosed in the forgoing, theserial data ports 210 may provide data from a wide variety of patientmedical devices, including electronic patient bed systems 214, infusionpump systems 216 including closed-loop control systems, ventilatorsystems 218, blood pressure or other vital sign measurement systems 220,or the like. Similarly, the channel data ports 212 may provide data froma wide variety of patient medical devices, including any of theforegoing, and other medical devices. For example, the channel dataports 212 may receive data from depth of consciousness monitors 222,such as those commercially available from Masimo Corporation of Irvine,Calif. under the SEDLine® and under the O₃™ Regional Oximetry for theRoot™ Patient Monitoring and Connectivity Platform™ brand names, brainor other organ oximetry devices 224, noninvasive blood pressure oracoustic devices 226, or the like. In an embodiment, a device that isconnected to the hub 100 through one or more of the channel data ports212 may include board-in-cable (“BIC”) solutions, where the processingalgorithms and the signal processing devices that accomplish thosealgorithms are mounted to a board housed in a cable or cable connector,which in some embodiments has no additional display technologies. TheBIC solution outputs its measured parameter data to the channel port 212to be displayed on the display 104 of hub 100. In an embodiment, the hub100 may advantageously be entirely or partially formed as a BIC solutionthat communicates with other systems, such as, for example, tablets,smartphones, or other computing systems.

Although illustrated with reference to a single docking station 106, theenvironment 200 may include multiple, stacked docking stations where asubsequent docking station mechanically and electrically docks to afirst docking station to change the form factor for a different portablepatent monitor. Such stacking may include more than 2 docking stations,and may reduce or increase the form factor for mechanical compliancewith mating mechanical structures on a portable device.

FIG. 3 illustrates a simplified hardware block diagram of the hub 100 ofFIGS. 1A-1C, according to an embodiment of the disclosure. As shown inFIG. 3, the housing 108 of the hub 100 positions and/or encompasses aninstrument board 302, the display 104, memory 304, and the variouscommunication connections, including the serial ports 210, the channelports 212, Ethernet ports 305, nurse call port 306, other communicationports 308 including standard USB or the like, and the docking stationinterface 310. The instrument board 302 comprises one or more substratesincluding communication interconnects, wiring, ports and the like toenable the communications and functions described herein, includinginter-board communications. A core board 312 includes the mainparameter, signal, and other processor(s) and memory. A portable patientmonitor board (“RIB”) 314 includes patient electrical isolation for theportable patient monitor 102 and one or more processors. A channel board(“MID”) 316 controls the communication with the channel ports 212,including optional patient electrical isolation and power supply 318. Aradio board 320 includes components configured for wirelesscommunications. Additionally, the instrument board 302 mayadvantageously include one or more processors and controllers, busses,all manner of communication connectivity and electronics, memory, memoryreaders including EPROM readers, and other electronics recognizable toan artisan from the disclosure herein. Each board comprises substratesfor positioning and support, interconnect for communications, electroniccomponents including controllers, logic devices, hardware/softwarecombinations and the like to accomplish the tasks designated above andothers.

An artisan will recognize from the disclosure herein that the instrumentboard 302 may comprise a large number of electronic components organizedin a large number of ways. Using different boards such as thosedisclosed above advantageously provides organization andcompartmentalization to the complex system.

Attention is now directed to embodiments of a user interface by which auser may interact with the hub 100. In particular, a touchscreen display104 is integral to the hub 100. An example of a physiological monitortouchscreen interface is disclosed in U.S. patent application Ser. No.13/850,000, assigned to the assignee of the present disclosure, and isincorporated by reference herein.

In general, the touchscreen interface provides an intuitive,gesture-oriented control for the hub 100. The touchscreen interfaceemploys interface constructs on the touchscreen display 104 that areparticularly adapted to finger control gestures so as to change at leastone of a physiological monitor operating characteristic and aphysiological touchscreen display characteristic. In particular, thetouchscreen display 104 presents a user with interface constructsresponsive to finger control gestures so as to change displays andsettings, such as monitor operating characteristics, display contentsand display formats.

FIG. 4 illustrates a legend of finger control gestures 400 for use witha touchscreen display 104 according to an embodiment. The finger controlgestures 400 include a touch 402, a touch and hold 404, a touch and move406, a flick 408, a drag and drop 410, and a pinch 412. A touch 402 is afinger control gesture that executes the desired action once the user'sfinger is released from the screen. A touch and hold 404 is a fingercontrol gesture that executes the desired action once the user has heldhis or her finger on the screen continuously for a predeterminedduration (e.g., a few seconds), received a “hold completion”notification, and has released his or her finger from the screen. Atouch and move 406 is a finger control gesture that manipulates and/ortranslates objects across the display 104 in the desired and permitteddirection to a deliberate stopping point. To execute a touch and movefinger control gesture 406, the user touches an object, moves the object(left, right, up, down, diagonally, etc.), and releases the object. Aflick 408 is a finger control gesture comprising contact of an object onthe display 104 in conjunction with a quick finger movement in aparticular direction, typically along a single vector. To execute aflick 408 finger control gesture the user touches an object on thedisplay 104, moves the object (typically, but not necessarily in asingle direction) and releases the finger from the display 104 quickly,in a manner such that the contact point has a velocity throughout itspath of motion. A drag and drop 410 is a finger control gesture by whichthe user moves an object to another location or to another object (e.g.,a folder) and positions it there by releasing it. To execute a drag anddrop 410 finger control gesture, the user touches, holds, drags anddrops the object. A pinch 412 is a finger control gesture that expandsor contracts the field of view on the display 104. To execute a pinch412 finger control gesture, the user touches the display 104 at twotouch points using two fingers, for example, the thumb and index fingerof a user's hand. Moving the touch points apart from each other zooms inon the field of view, enlarging it, while moving the touch pointstogether zooms out on the field of view, contracting it.

In an embodiment the user interface includes multiple controls. Forexample, a toggle control enables a user to slide a knob to switchbetween toggle states. The toggle control also enables the user to pressleft or right of the toggle to quickly move the toggle left or right. Ifthe toggle control is labeled, the user can press the label to quicklymove the knob left or right.

The following paragraphs include a description of additional touchscreen controls that can be used with the system of the presentdisclosure. The system can include any combination of the followingcontrols and the present disclosure is not intended to be limited by thefollowing descriptions of various controls.

In some embodiments, a spinner control enables the user to press acenter (focused) tile to expand a spinner when the spinner is closed andto collapse a spinner when the spinner is opened. The spinner controlenables the user to swipe up or down which, when the spinner is open,scrolls through spinner tiles. The spinner control enables the user topress an unfocused tile which then scrolls the tile into a center,focused position. And the spinner control enables the user to collapsean open spinner by pressing anywhere outside the spinner.

A slider control enables the user to move a knob by sliding the knob.The slider control also enables the user to quickly move the knob to aspecific position by pressing anywhere along the slider path.

A slider spinner control combines the control capabilities of thespinner control and the slider control.

A button control enables a user to perform an action, as defined by thebutton description, by pressing the button.

An icon menu control enables the user to open a specified menu bypressing a tile. The icon menu control enables the user to scroll iconsleft or right by swiping left or right anywhere on the display. The iconmenu control enables the user to quickly center a tile corresponding toan indicator icon by pressing an indicator button.

A window control enables the user to open a parameter or measurementwindow when no parameter or measurement alarm is present, by pressingthe parameter or measurement. The window control enables the user tosilence a parameter or measurement alarm when a parameter or measurementalarm is present, by pressing the parameter or measurement. The windowcontrol enables a parameter or measurement to be moved to a differentlocation on the display 104 by using a drag and drop 410 finger controlgesture.

A well control enables the user to open a parameter or measurement menuwhen no parameter or measurement alarm is present, by pressing theparameter or measurement. The well control enables the user to silence aparameter or measurement alarm when a parameter or measurement alarm ispresent, by pressing the parameter or measurement.

A live waveform control enables the user to separate waveforms byswiping down. The live waveform control enables the user to combinewaveforms by swiping up.

A trend line control enables the user to zoom in by pinching in, zoomout by pinching out, change a time range by panning, and open aparameter or measurement trend menu by pressing the y-axis.

An alarm silence icon control enables the user to silence all alarms bypressing the alarm silence icon.

An audio pause icon control enables the user to pause audio for apredetermined period of time, by pressing the audio pause icon.

Other status bar icon controls enable the user to open the relevantmenu, by pressing the relevant status bar icon.

A back arrow control enables the user to exit a menu or abandon anychanges made, by pressing a back arrow icon.

A confirm-or-cancel control enables the user to confirm changes tosettings by pressing an OK button. The confirm-or-cancel control enablesthe user to cancel changes to settings by pressing a cancel button.

A home control enables the user to navigate to the main screen at anytime by pressing a home button.

FIG. 5 illustrates an embodiment of a user interface 500 displayed onthe display 104 of the hub 100. In an embodiment the display 104comprises a color, modular, touchscreen integral to the hub 100.Positioned horizontally along the top of the display 104 is a top statusline 501 that displays system status as well as that provide shortcutsto menu items or actions. In an embodiment the icons presented on thetop status line 501 include alarm silence 501A, audio pause 501B,profiles 501C, Bluetooth 501D, Wi-Fi 501E, Ethernet 501F, connectivitygateway 501G, portable patient monitor battery status 501H, monitoringhub battery status 501I, sounds 501J, and current time 501K. The alarmsilence icon 501A displays alarm status and mutes all audible alarms formonitoring devices connected to the hub 100. The audio pause icon 501Bdisplays audio pause status and temporarily silences an alarm event. Theprofiles icon 501C provides access to a profiles screen; the exampleshown illustrates that the profile is set to “Adult” for an adultpatient. The Bluetooth icon 501D provides access to a Bluetooth screen.If this icon is visible on the status line 501, then Bluetoothconnectivity has been enabled. The Wi-Fi icon 501E provides access to aWi-Fi screen. If this icon is visible on the status line 501, then Wi-Ficonnectivity has been enabled. The icon itself also indicates thestrength of the wireless signal. The Ethernet icon 501F provides accessto an Ethernet screen. If this icon is visible on the status line 501,then Ethernet connectivity has been enabled. The connectivity gatewayicon 501G provides access to a connectivity gateway screen. The exampleillustrated indicates that standalone devices are connected to three ofthe available four ports. The color of the icon matches the statuscolors of the connected standalone devices. The portable patient monitorbattery status icon 501H displays the charging status of the portablepatient monitor 102 and provides access to a portable patient monitorbattery screen. The example illustrates that the battery is currentlycharging. The monitoring hub battery status icon 501I displays thecharging status of the monitoring hub 100 and provides access to amonitoring hub battery screen. The example illustrates that the batteryis currently charging. The sounds icon 501J provides access to a soundsscreen to adjust alarm and pulse tone volume. In an embodiment thesounds icon 501J does not indicate the actual volume level of the alarmand the pulse tone. The current time icon 501K displays the current timeand provides access to a localization screen which contains settingsrelated to local time, language and geography.

Positioned horizontally along the bottom of the display 104 is a bottomstatus line 502 that displays additional icons and information includinga main menu icon, a gender icon, and a patient identifier that includespatient-specific information, such as, for example, the patient's nameand room location. Although the disclosed embodiment employs statuslines 501, 502 oriented horizontally along the top and bottom of thedisplay 104, one skilled in the art would readily appreciate thatinformation of the type presented in the top status line 501 and in thebottom status line 502 may be presented in numerous different formats,combinations and configurations, including without limitation, one ormore status bars positioned vertically on the display 104. Moreover askilled artisan will appreciate that other useful information may bedisplayed in status bars 501, 502.

In an embodiment the user interface creates a window for everymonitoring device connected to the hub 100. Parameters or measurementscan be expanded within a window to customize views. A central portion504 of the display 104 presents patient measurement data, in thisexample, in two windows 506, 530. An upper window 506 presents patientdata measured by an a noninvasive monitoring platform—such as therainbow® Pulse CO-Oximetry™ monitoring platform by Masimo Corporation ofIrvine, Calif.—which enables the assessment of multiple bloodconstituents and physiologic parameters including oxygen saturation(SpO₂) 508, pulse rate (PR) 510, respiration rate (RRp) 512, fractionalarterial oxygen saturation (SpfO₂) 514, total hemoglobin (SpHb) 516,plethysmograph variability index (PVI) 518, methemoglobin (SpMet) 520,carboxyhemoglobin (SpCO) 522, perfusion index (PI) 524, and oxygencontent (SpOC) 526.

Advantageously, the display 104 is configurable to permit the user toadjust the manner by which the physiologic parameters are presented onthe display 104. In particular, physiologic measurements of greaterinterest or importance to the clinician may be displayed in largerformat and may also be displayed in both numerical and graphical formatsto convey the current measurement as well as the historical trend ofmeasurements for a period of time, such as, for example, the precedinghour. In an embodiment the oxygen saturation 508, pulse rate 510, andrespiration rate 512 measurements are displayed in such a manner, takingup a larger portion of the upper portion 506 of the display 104, whilethe fractional arterial oxygen saturation 514, total hemoglobin 516,plethysmograph variability index 518, methemoglobin 520,carboxyhemoglobin 522, perfusion index 524, and oxygen content 526measurements are displayed as numbers, taking up a smaller portion ofthe upper portion 506 of the display 104.

In an embodiment the presentation of measurement information may beadjusted easily by using the finger control gestures 400. For example,the touch and move 406 finger control gesture may be used to move anobject on the display 104 representing a measurement from one locationof the display 104 to another location of the display 104.Advantageously, when the object is moved, the display 104 automaticallyscales its presentation of information based upon the parameters thatare active. For example, fewer parameters result in the presentation oflarger digits, trend lines, and waveform cycles. In an embodiment thelocation to which an object is moved determines, at least in part, themanner by which that object will be presented on the display 104.

A lower window 530 of the display 104 presents patient data measured bya regional oximetry platform—such as the O₃™ regional oximetry module byMasimo Corporation of Irvine, Calif.—which allows the continuousassessment of tissue oxygenation beneath one or more sensors placed onthe patient's skin to help clinicians detect regional hypoxemia.Regional oximetry—also referred to as tissue oximetry and cerebraloximetry—enables the continuous assessment of the oxygenation of tissuebeneath the sensor. Simultaneous measurement of both tissue oxygensaturation (rSO₂) and arterial blood oxygenation (SpO₂) providesclinicians, such as anesthesiologists or perfusionists, a differentialanalysis of regional-to-central oxygen saturation monitoring, whichhelps the clinician to maintain brain oxygenation and safe cerebralperfusion during procedures.

In an embodiment the regional oximetry module is configured by applyingone or more regional oximetry sensors to the patient, for example, thepatient's forehead, and by connecting the module(s) to the hub 100. Inan embodiment the regional oximetry module has as few as one and as manyas four sensors. In an embodiment the regional oximetry module isconnected to the hub 100 through the hub's 100 channel ports 212.

In an embodiment the regional oximetry platform uses near-infraredspectroscopy (NIRS) to continuously and simultaneously measure regionaloxygen saturation (rSO₂) and arterial oxygen saturation (SpO₂), enablingthe regional oximetry platform to automatically derive the differentialanalysis of a patient's regional-to-central oxygen saturation. In anembodiment the hub 100 derives the differential analysis of a patient'sregional-to-central oxygenation saturation by comparing measurementsprovided to the hub 100 from two sources, such as a pulse oximetrymeasurement device and a regional oximetry measurement device.

FIGS. 6A-6B illustrate regional oximetry monitor user interfaceembodiments for designating adult and child sensor placement sites. Asshown in FIG. 6A, an adult form 601 is generated on a user interfacedisplay. In an embodiment, between one and four sensor sites can bedesignated on the adult form 601, including left and right forehead 610,left and right forearm 620, left and right chest 630, left and rightupper leg 640, left and right upper calf 650 and left and right calf 660sites. Accordingly, between one and four sensors can be located onvarious combinations of these sites. The hub 100, which is incommunication with these sensors, displays between one and fourcorresponding regional oximetry graphs and readouts, as described withrespect to FIGS. 7 and 8, below. In other embodiments, any number ofsensors and sensor sites can be used, including all of the sensor sitesillustrated in FIG. 6A and/or other sensor sites as well.

As shown in FIG. 6B, a child form 602 is generated on a user interfacedisplay. In an embodiment between one and four sensor sites can bedesignated on the child form 602, including left and right forehead 610,left and right renal 670, and left and right abdomen 680 sites.Accordingly, between one and four sensors can be located on these sites.The hub 100, which is in communication with these sensors, displaysbetween one and four corresponding regional oximetry graphs andreadouts, as described in FIGS. 7 and 8 bellow. In other embodiments,any number of sensors and sensor sites can be used, including all of thesensor sites illustrated in FIG. 6B and/or other sensor sites as well.

FIG. 7 illustrates an embodiment of a regional oximetry window display700 for monitoring parameters derived from one or more regional oximetrysensors. This particular example is a two-sensor display for monitoring,for example, a forehead left 710 site and a forehead right 730 site. Inan upper portion of the display 700, the forehead left 710 sitedisplays, for example, an Sp0₂ graph 712, an rS0₂ graph 714 and an rS0₂readout 716. Similarly, the forehead right 730 site displays, forexample, an Sp0₂ graph 732, an rS0₂ graph 734 and an rS0₂ readout 736.In other embodiments, any number of sensors and sensor sites can beused.

Also shown in FIG. 7, in a lower portion of the display 700, is aforehead left display well 750 that displays, for example, an Sp0₂readout 752, a ΔSp0₂ readout 754 and a Δbase readout 756. Similarly, theforehead right display well 730 displays, for example, an Sp0₂ readout772, a ΔS0₂ readout 774 and a Δbase readout 776.

FIG. 8 illustrates an embodiment of the user interface 800 in which aregional oximetry parameter display 104 accommodates four regionaloximetry sensor inputs. In this example, a first two-sensor display 801is enabled for monitoring a forehead left site 810, 830 and a foreheadright site 820, 840. A second two-sensor display 802 is enabled formonitoring a chest left site 850, 870, and a chest right site 860, 880.Notably, a pulse oximetry parameter display 805 is allocated lessdisplay space than the regional oximetry parameter display 806 toaccommodate the graphical area needed to display the regional oximetryparameter data. In an embodiment the display 800 automatically scales toallocate display space according to preferences set by the user. Inother embodiments, any number of sensors and sensor sites can be used.

FIGS. 9A-9B generally illustrate embodiments for regional oximetrymonitoring. As shown in FIG. 9A, a regional oximetry pod array 900 has afirst pod assembly 910 and a second pod assembly 920. Each pod assembly910, 920 communicates with an array of one or two regional oximetrysensors 960 via sensor cables 950. In other embodiments the podassemblies 910, 920 can communicate with any number of regional oximetrysensors 960. The sensors 960 are attached to various patient locations,with one or two regional oximetry pods 930 and a corresponding number ofpod cables 940 providing communications between the pods 930 and the hub100. In other embodiments any number of sensors, positioned at anynumber of sensor sites on the patient's body can be used, and any numberof pod assemblies can be used to connect the sensors to the hub 100. Thepods 930 perform the physiological sensor signal processing normallyassociated with a monitoring device, which advantageously allowsregional oximetry pods 930 to easily integrate with third party monitors100 ranging from relatively “dumb” display devices that perform littleor no signal processing to relatively “intelligent” multi-parameterpatient monitors, which communicate with a variety of sensors and whichperform sophisticated signal processing at the monitor level.

As shown in FIG. 9B, a regional oximetry pod assembly 911 embodiment hasa pod 931 that communicates with up to two regional oximetry sensors 961via sensor cables 951. In other embodiments the pod 931 can communicatewith any number of regional oximetry sensors 961. In turn, the pod 931communicates with an attached monitor hub 100 via a pod cable 941. In anembodiment the pod cable 941 connects to one of the channel ports 212 ofthe hub 100.

Embodiments of user interfaces for configuring a regional oximetrysystem to operate with a hub 100 follow.

When multiple regional oximetry sensors 960 are positioned on apatient's body and connected to the hub 100, there is a potential forconfusion as to where each sensor is positioned on the patient. Thispotential for confusion is increased when, as in some embodiments, podassemblies 920, 930 are used to connect multiple sensors 960 to the hub100 because embodiments of pod assemblies 920, 930 can connect multiplesensors 960 to a single channel port 212 of the hub 100. Inadvertentmislabeling of sensor location can lead to misreading of thephysiological data being displayed, thereby posing a risk to thepatient. Advantageously embodiments of the user interface forconfiguring a regional oximetry system to operate with a hub 100,disclosed herein, address this concern by displaying informationdescribing the connectivity status and configuration of sensors 960, podassemblies 920, 930 and channel ports 212. In some embodiments theinformation describing the connectivity status and configurationincludes visual representations to assist clinicians in properlylabeling and configuring the hub 100 to work appropriately with aregional oximetry system.

FIGS. 10A-10F illustrate embodiments of a user interface for selecting afirst sensor site employing a menu-based, hierarchical navigationstructure. FIG. 10A illustrates a main menu 1000A which is accessed bypressing a main menu icon 1000. The main menu presents several optionsfor the user to select. The main menu options permit the user tonavigate to various features of the user interface. Main menu optionsinclude, without limitation, device settings, information, trendsettings, profiles, connectivity, layout, and sounds. As depicted inFIG. 10A, a regional oximetry device icon 1001 is selected using a touch402 finger control gesture, which causes the display 104 to replace themain menu with a regional oximetry menu 1000B, illustrated in FIG. 10B.Selection of the sensor sites icon 1002 opens a sensor sites menu 1000Cshown in FIG. 10C. As illustrated in FIG. 10C a connectivity window 1003graphically displays the connectivity state of the channel ports 212 ofthe hub 100. In this illustrative example, pod 1 1004 is connected toport 1 1006, and sensor cable 1 1008 is connected to pod 1 1004. Asensor 1 button 1010 is illuminated to indicate that sensor 1 isconnected. In contrast, a sensor 2 button 1012 is not illuminated (orgrayed-out), indicating that no sensor cable is connected to it. Aninformation line 1014 instructs the user to select a sensor 1 site. Asillustrated, an adult form 1016 is generated to display potential sitesof the patient's body where a regional oximetry sensor can be placed,including right and left forehead, right and left forearm, right andleft chest, right and left upper leg, right and left upper calf, andright and left calf. With the touch finger control gesture 402 the userselects a sensor location on the adult form 1016 to identify where, onthe patient, the regional oximetry sensor has been placed. Asillustrated in FIG. 10C the left forehead sensor site 1018 is selected.

FIG. 10D illustrates a confirmation user interface display 1000D forselecting a first sensor site. The left forehead sensor site 1018changes color, for example from white to blue, and the numeral “1”appears on the left forehead sensor site 1018, indicating that thesensor 1 site has been selected. Additionally the information line 1014indicates that the sensor site has been selected by stating “SENSOR 1:FOREHEAD LEFT.” The user is prompted to confirm the sensor siteselection by touching an OK button 1020.

FIG. 10E illustrates an embodiment of a user interface in which thepatient is a child 1000E. A child form 1022 is generated to displaypotential sites of the patient's body where a regional oximetry sensorcan be placed, including right and left forehead, right and left renaland right and left abdomen. In this example, the left forehead sensorsite 1018 changes color, for example from white to blue, and the numeral“1” appears on the left forehead sensor site 1018, indicating that thesensor 1 site has been selected. Additionally the information line 1014indicates that the sensor site has been selected by stating “SENSOR 1:FOREHEAD LEFT.” The user is prompted to confirm the sensor siteselection by touching an “OK” button 1020.

FIG. 10F illustrates an embodiment of a user interface display in whicha sensor 1 is configured and monitoring the patient's regional oximetryof the left forehead 1000F. In this example, a two-sensor window 1030 isenabled for monitoring a forehead left site 1032, 1034. Configuration ofadditional pods, selection of additional sensor sites, and modificationof sensor sites can be performed in a similar manner to that describedwith respect to FIGS. 10A-F.

FIGS. 11A-11D illustrate embodiments of a user interface for setting abaseline for a regional oximetry sensor. The baseline is a reading ofthe patient's regional oximetry level before a patient is sedated. Thebaseline is compared with the patient's sedated regional oximetrymeasurements to assess whether the patient is being adequatelyoxygenated during, for example, a procedure.

FIG. 11A illustrates an embodiment of a graphical display 1100A in whichtwo regional oximetry sensors are positioned on the patient, wheresensor 1 is positioned on the left forehead and sensor 2 is positionedon the right forehead. To initiate the process of setting a baselinefor, say, sensor 1, the user selects a Δbase icon 1102 using a touchfinger gesture 402. As illustrated in FIG. 11B, a sensor 1 deltabaseline menu 1100B appears. By selecting the set baseline icon 1103, aset baseline display 1100C appears as illustrated in FIG. 11C. Abaseline action screen 1104 appears with an information line 1105instructing the user to set a baseline for sensor 1. The user enablesthe baseline feature for sensor 1 by sliding a toggle switch 1106 intothe “on” position using, for example, a touch and move 406 fingercontrol gesture. An arrow icon 1108 allows the user to navigate back tothe previous screen if desired. Advantageously, while the user isengaged in configuring the hub 100 by engaging action screens, monitoreddata is displayed in the background with brightness reduced. FIG. 11Dillustrates an updated set baseline display 1100D. The action screen1104 expands to include a baseline setting slider 1110 and a numericaldisplay 1112. As the user slides the baseline setting slider 1112 leftor right, using for example the touch and move 406 finger controlgesture, a corresponding numerical value is indicated on the numericaldisplay 1112. FIG. 11E illustrates an embodiment 1100E in which thebaseline is set by using a flick 408 finger control gesture on thenumerical display 1112. In this example the user confirms the sensorsite selection by touching an “OK” button 1114, and the action screen1104 closes returning the user interface display 1100F to its previouslevel of brightness, as illustrated in FIG. 11F. The Abase object 1102now displays a numerical value, indicating that the baseline feature hasbeen enabled and set. Setting baselines for additional sensor sites canbe performed in a similar manner as to that described herein.

Referring back to FIG. 11B, by selecting the alarms icon 1107, the usernavigates to a menu to set sensor 1 delta baseline alarms 1100G,illustrated in FIG. 11G. A delta baseline alarms action screen 1120appears in which the user can set alarm conditions for the monitoring ofsensor 1 delta baseline information. In an embodiment the alarmconditions include a delta limit 1122, a delta caution range 1124, and asilence duration 1126. Advantageously the alarm conditions can be usedto graphically represent the status of the delta baseline metric on atrend view, as described below with respect to FIGS. 15A-B.

In an embodiment the hub 100 displays a differential analysis of apatient's regional-to-central oxygen saturation, also referred to asΔSpO₂, where measurement of the patient's arterial oxygen saturation iscompared with one or more measurements of regional oxygen saturation.The source of measurements of the patient's arterial oxygen saturationused to determine the patient's regional-to-central oxygen saturationcan be provided by the regional oximetry sensor or by a peripheralarterial oxygen sensor. FIGS. 12A-12E illustrate embodiments of a userinterface for setting a source for measuring arterial oxygen saturationfor determining a patient's regional-to-central oxygen saturation. FIG.12A illustrates an embodiment of a user interface 1200A in which tworegional oximetry sensors are positioned on the patient, where sensor 1is positioned on the left forehead and sensor 2 is positioned on theright forehead. To initiate the process of setting a delta SpO₂ sourcefor, say, sensor 2, the user selects a ΔSpO₂ icon 1202 using a touchfinger gesture 402. As illustrated in FIG. 12B, a delta SpO₂ screen1200B appears with three delta SpO₂ menu icons on the display includinga “set SpO₂ delta source” icon 1204, an “alarms” icon 1206, and an“about delta baseline” icon 1208. When the user selects the “set SpO₂delta source” icon 1204, an SpO2 delta source display 1200C appears. Adelta source action screen 1210 appears, as illustrated in FIG. 12C. Theinformation line instructs the user to select an SpO2 delta source forsensor 2. The user selects the SpO2 delta source for sensor 2, in thiscase, by sliding a toggle switch icon 1212 either to the regionaloximetry sensor location—which in this case is identified as forehead—orto a peripheral setting, using a touch and move 406 finger controlgesture. As illustrated in FIG. 12D, once the SpO2 delta source isselected (to forehead in this illustration) the user is prompted toconfirm the delta source selection by touching an “OK” button 1214.Alternatively, the user can cancel the delta source selection bytouching a “cancel” button 1216. The action screen 1210 then closesreturning the main display 1200E to its previous level of brightness, asillustrated in FIG. 12E, indicating that in this embodiment, the sensor2 SpO₂ delta source is set.

Referring back to FIG. 12B, by selecting the alarms icon 1205, the usernavigates to a menu to set sensor 2 delta SpO₂ alarms 1200F, illustratedin FIG. 12F. A delta baseline alarms action screen 1220 appears in whichthe user can set alarm conditions for the monitoring of sensor 2 deltabaseline information, including a delta limit 1222, a delta cautionrange 1224, and a silence duration 1226.

FIGS. 13A-13E illustrate embodiments of a user interface for settingparameters of a sensor used in a regional oximetry system to operatewith the hub 100. The user navigates from the main menu and the regionaloximetry menu (described above with respect to FIGS. 10A-B) to arriveat, say, a sensor 1 menu 1300A, as illustrated in FIG. 13A. By selectinga regional oxygen saturation icon 1302, the user navigates to a menu forsensor 1 regional oxygen saturation (rSO₂) settings 1300B as illustratedin FIG. 13B. Similarly, by selecting an alarms icon 1308, the usernavigates to a screen for setting sensor 1 rSo₂ alarms 1300C whichdisplays an action screen 1314 for setting sensor 1 regional oxygensaturation (rSO₂) alarms, as illustrated in FIG. 13C. In an embodimentthe alarms include high limit, low limit, high caution range, lowcaution range, and silence duration. The action screen 1314 featuresbuttons to turn on or off various alarms and sliders by which the usercan set parameters, such as limits, ranges and durations, to establishalarm triggering conditions for a given sensor positioned on a patient.

Referring back to the sensor menu of FIG. 13A, the user can select theoxygen saturation icon 1304 to navigate to, for example, the sensor 1oxygen saturation (SpO₂) settings menu 1300D, illustrated in FIG. 13D.By selecting an alarms icon 1316, the user navigates to a sensor 1 SpO2alarms menu 1300E displaying an action screen 1318 for setting sensor 1oxygen saturation (SpO₂) alarms, as illustrated in FIG. 13E. In anembodiment the alarms include high limit, low limit, high caution range,low caution range, rapid desaturation, alarm delay and silence duration.The action screen 1318 features buttons to turn on or off variousalarms, sliders by which the user can set parameters, such as limits,ranges and durations, to establish alarm triggering conditions for agiven patient. Advantageously the alarm conditions can be used tographically represent the status of the delta baseline metric on a trendview, as described below with respect to FIGS. 15A-B.

FIG. 14 illustrates an embodiment of a monitor display 1400 in whichregional oximetry baseline delta measurements are presented. In thisembodiment a two-sensor display 1402 is configured to present monitoredpatient data from the patient's left forehead 1404, 1406 and from thepatient's right forehead 1408, 1410. A baseline view icon 1412 isselected which results in formatting the patient's measured data to bepresented graphically, with a baseline that has been set by the user, atthe trend displays 1404, 1408. In the present example illustrated inFIG. 14 the baseline is set to 82 for both sensor 1 (positioned on thepatient's left forehead) and sensor 2 (positioned on the patient's rightforehead). Accordingly the user readily sees differences between themeasured regional oximetry and a baseline level. Additionally, thepresent difference between the measured regional oximetry and thebaseline is displayed numerically at well displays 1406, 1410 next tothe Δbase label.

FIG. 15A illustrates an embodiment of a monitor display 1500A in which,among other things, the patient's regional-to-central oxygenationsaturation measurements, or SpO₂ delta, are presented. In thisembodiment a two-sensor window display 1502 is configured to presentmonitored patient data from the patient's left forehead 1504, 1506 andfrom the patient's right forehead 1508, 1510. A trend view icon 1512 isselected which, in this example, results in formatting the patient'smeasured data to be presented graphically with two trend lines: a firstline representing measured arterial oxygen saturation 1514 and a secondline representing regional oxygen saturation 1516 thereby visuallyreflecting the difference between the two measurements. In an embodimentthe first line 1514 is displayed in a first color, for example, white,and the second line 1516 is displayed in a second color, for example,blue. Accordingly the user readily sees differences between the measuredarterial oxygen saturation and the measured regional oxygen saturationand is able to distinguish one measurement form the other. Additionally,the present difference between the measured arterial oxygen saturationand measured regional oxygen saturation is displayed numerically at welldisplays 1506, 1510 next to the ΔSpO₂ label.

Advantageously the area 1528 between the first line representingmeasured arterial oxygen saturation 1514 and the second linerepresenting regional oxygen saturation 1516 is shaded with varyingcolors to visually indicate the state of the metric, in this case, thepatient's regional-to-central oxygenation saturation measurements, orSpO₂ delta. In an embodiment the area 1528 is shaded with, for example,a green color when no alarm or caution range is met, a yellow color whena caution range is met, and a red color when an alarm limit is met orexceeded, thereby visually alerting the user to circumstances that mightrequire attention or clinical action. As illustrated in FIG. 15A aportion 1530 of the area 1528 between the first line representingmeasured arterial oxygen saturation 1514 and the second linerepresenting regional oxygen saturation 1516 for sensor 1 is shaded toindicate that the regional oximetry measurement of the patient's leftforehead entered into the caution range.

FIG. 15B illustrates an embodiment of a monitor display 1500B configuredas the one in FIG. 15A, however multiple alarms are triggered. Theseinclude an alarm that the patient's left forehead regional oxygensaturation is less than 50 percent 1520, an alarm that theregional-to-central oxygen saturation measurements of the patient's leftforehead region differ by 55 percentage points 1522, and an alarm thatthe patient's left forehead regional oxygen saturation is 43 percentagepoints below the patient's baseline 1524. In an embodiment the alarmconditions are highlighted visually with bold borders that are, forexample, bright red in color. Additionally the alarm silence icon 1526is illuminated in, for example, bright red. The alarm silence icon 1526is an indicator as well as a functional button. It always indicates thepresence (or lack of presence) of alarms, and it can be used totemporarily suspend audible alarms for a predetermined amount of time,known as the silence duration. When the alarm silence icon isilluminated red, it signals that there is currently at least one activealarm that has not been silenced.

As previously described the area 1528 between the first linerepresenting measured arterial oxygen saturation 1514 and the secondline representing regional oxygen saturation 1516 is shaded with varyingcolors to visually indicate the state of the metric, in this case, thepatient's regional-to-central oxygenation saturation measurements, orSpO₂ delta. As illustrated in FIG. 15B a portion 1532 of the area 1528between the first line representing measured arterial oxygen saturation1514 and the second line representing regional oxygen saturation 1516for sensor 1 is shaded to indicate that the regional oximetrymeasurement of the patient's left forehead entered into the cautionrange and into the alarm limit range. For easy reference, a dotted line1534 indicates the alarm limit as set by the user.

A regional oximetry user interface has been disclosed in detail inconnection with various embodiments. These embodiments are disclosed byway of examples only and not to limit the scope of the claims thatfollow. One of ordinary skill in the art will appreciate from thedisclosure herein any variations and modifications.

The term “and/or” herein has its broadest least limiting meaning whichis the disclosure includes A alone, B alone, both A and B together, or Aor B alternatively, but does not require both A and B or require one ofA or one of B. As used herein, the phrase “at least one of” A, B, “and”C should be construed to mean a logical A or B or C, using anon-exclusive logical or.

As used herein, the term module may refer to, be part of, or include anApplication Specific Integrated Circuit (ASIC); an electronic circuit; acombinational logic circuit; a field programmable gate array (FPGA); aprocessor (shared, dedicated, or group) that executes code; othersuitable components that provide the described functionality; or acombination of some or all of the above, such as in a system-on-chip.The term module may include memory (shared, dedicated, or group) thatstores code executed by the processor.

The apparatuses and methods described herein may be implemented by oneor more computer programs executed by one or more processors. Thecomputer programs include processor-executable instructions that arestored on a non-transitory tangible computer readable medium. Thecomputer programs may also include stored data. Non-limiting examples ofthe non-transitory tangible computer readable medium are nonvolatilememory, magnetic storage, and optical storage.

Although the foregoing has been described in terms of certain preferredembodiments, other embodiments will be apparent to those of ordinaryskill in the art from the disclosure herein. Additionally, othercombinations, omissions, substitutions and modifications will beapparent to the skilled artisan in view of the disclosure herein.Accordingly, the present invention is not intended to be limited by thedescription of the preferred embodiments, but is to be defined byreference to the claims.

Additionally, all publications, patents, and patent applicationsmentioned in this specification are herein incorporated by reference tothe same extent as if each individual publication, patent, or patentapplication was specifically and individually indicated to beincorporated by reference.

What is claimed is:
 1. A regional oximetry system comprising: a display;and at least one processor, the processor causing a plurality of viewsto be displayed on the display, each view configured to occupy at leasta portion of the display, each of the views adapted to present dataresponsive to at least one physiological signal; a first sensor portconfigured to receive a first physiological signal representative of aregional tissue oxygenation level; a second sensor port configured toreceive a second physiological signal representative of an arterialoxygen saturation level; the processor configured to set a baselinelevel representative of an acceptable state of the regional tissueoxygenation; wherein one of the views presents (i) a differentialanalysis of the regional tissue oxygenation level and the arterialoxygen saturation level, and (ii) the baseline level.
 2. The regionaloximetry system according to claim 1 wherein the one of the views thatpresents the differential analysis presents a numerical representationof (i) the differential analysis and (ii) the baseline level aspresently measured.
 3. The regional oximetry system according to claim 1wherein the one of the views that presents the differential analysispresents a graphical representation of (i) the differential analysis and(ii) the baseline level.
 4. The regional oximetry system according toclaim 3 wherein the graphical representation of the (i) differentialanalysis and (ii) the baseline level includes trend information.
 5. Theregional oximetry system according to claim 1 wherein the one of theviews that presents a differential analysis comprises a first view thatpresents a numerical representation of the (i) differential analysis and(ii) the baseline level, and the plurality of views also comprise asecond view that presents a graphical representation of (i) thedifferential analysis and (ii) the baseline level.
 6. The regionaloximetry system according to claim 1 wherein the processor furthercauses a set baseline menu view to be displayed on the display so as tooccupy at least a portion of the display, and wherein the set baselinemenu is adapted to present baseline display configuration informationand baseline display configuration selections, the baseline menucomprising: an enable toggle; a baseline slider; and a baseline spinner;wherein the baseline slider and the baseline spinner are adapted toenable manual setting of the baseline level.